Bone Quality

Bone strength is determined by several properties, especially bone mass, which is measured using ionizing radiation (DEXA scan). Another technique used to evaluate bone strength uses ultrasound waves to describe two other properties of bone that are also related to bone strength: elasticity and structure. As the ultrasound wave passes through the heel bone (os calcis), the wave is altered. The way in which the ultrasound wave is altered describes the elasticity and structure of the bone. These two properties are combined into the term “Stiffness Index”. Studies have shown that Stiffness Index is related to bone density, making it a good indicator of bone strength.

U.S. National Library of Medicine (NLM)

I have asked the U.S. National Library of Medicine (NLM) to add strontium citrate to their list of alternative therapies for osteoporosis. To contact the agency, use http://www.nlm.nih.gov/medlineplus/osteoporosis.html.

Heel Ultrasound Predicts Osteoporosis Risk

News from the RSNA Journal Radiology
June 24, 2008
Simple Ultrasound Exam May Predict Osteoporosis Risk At A Glance


An ultrasound exam of the heel may be able to predict if a woman is at heightened risk for fractures due to osteoporosis, according to a new multicenter study being published in the July issue of the journal Radiology. Along with certain risk factors, including age or recent fall, radiation-free ultrasound of the heel may be used to better select women who need further bone density testing, such as a dual-energy x-ray absorptiometry (DXA) exam.

In the three-year multicenter study, 6,174 women age 70 to 85 with no previous formal diagnosis of osteoporosis were screened with heel-bone quantitative ultrasound (QUS), a diagnostic test used to assess bone density. QUS was used to calculate the stiffness index, which is an indicator of bone strength, at the heel. Researchers added in risk factors such as age, history of fractures or a recent fall to the results of the heel-bone ultrasound to develop a predictive rule to estimate the risk of fractures.

In the group of higher risk women, 290 (6.1 percent) developed fractures whereas only 27 (1.8 percent) of the women in the lower risk group developed fractures. Among the 66 women who developed a hip fracture, 60 (90 percent) were in the higher risk group.

The results show that heel QUS is not only effective at identifying high-risk patients who should receive further testing, but also may be helpful in identifying patients for whom further testing can be avoided.

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